Im not too sure how much this will help you,but have you had a look at the ASSET assesment form used by youth offending teams. It is based upon Farrington's theory on risk and protective factors which influence offending behaviour.
The assesment form has 12 sections that cover a multitude of risk factors such as Age, Health, family, neighbourhood, substance misuse and others. It sounds like it may cover all you need.
Good Luck